TreatmentUpdate57, Vol. 7, No. 3 - March 1995
Sean Hosein

In this project, researchers have been keeping track of babies born to HIV-infected mothers. The mothers were asked not to breast feed their infants. Here is the subject profile:

- average age was about 27 years - about 1/4 were from Central Africa - about 5 % were from the West Indies - 80% had either no symptoms or just persistently swollen lymph nodes - average CD4+ cell count was roughly 600 cells - average % of lymphocytes that were CD4+ was 30% - average CD8+ cell count was 864 cells - average % of lymphocytes that were CD8+ was 44%

No women used anti-HIV drugs during the study.

* TRANSMISSION RATE OF 20%

The researchers reported data on 848 mothers (and their children). They found that about 20% of babies had HIV infection. The transmission rate has remained roughly the same since 1986. Researchers analysed other data to find out what factors might affect the infection of babies. They found that the following factors did not have any relation to the infant being HIV-infected:

- being born in Central Africa - cutting open the mother's womb to release the infant - whether the mother was infected through needles or sex

The following factors appeared to be associated with infection of the fetus:

- breast-feeding - age-older mothers - low CD4+ cell counts (explained below) - detectable p24 antigen - symptoms of HIV infection

On average, women who had a CD4+ cell count of 601 cells or more had a 15% chance of giving birth to an infected infant. Women who had less than 200 CD4+ cells had a 43% chance of giving birth to an infected infant. These differences were statistically significant; that is, not likely due to chance alone. Women with the lowest risk of transmission (12%) had more than 500 CD4+ cells and less than 40% of CD8+ cells. Women with the highest risk (50%) of transmission had less than 200 CD4+ cells and more than 40% CD8+ cells. The length of time infants were breast fed did not seem to affect which infants would become HIV-infected. Mothers who were more than 35 years old had a transmission rate of 30% and those under the age of 25 had a rate of less than 16%. Subjects with no symptoms of HIV infection had an 18% risk of transmission while those with AIDS had a rate of 35%.

REFERENCES:

1. Mayaux M-J, Blanche S, Rouzioux C, et al. Maternal factors associated with perinatal HIV-1 transmission: the French cohort study-7 years of follow-up observation. Journal of Acquired Immunodeficiency Syndromes and Human Retro- virology 1995;8(2):188-194.

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